Healthcare Provider Details

I. General information

NPI: 1346745668
Provider Name (Legal Business Name): DEENA HOSSINO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 SE RIVERSIDE DR STE 200
STUART FL
34994-2579
US

IV. Provider business mailing address

509 SE RIVERSIDE DR STE 200
STUART FL
34994-2579
US

V. Phone/Fax

Practice location:
  • Phone: 877-463-2010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA185477
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME175182
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: